What is PMDD?
Premenstrual dysphoric disorder is not PMS with a fancy name. It is a condition where hormonal changes before your period trigger severe depression, anxiety, irritability, or mood swings -- intense enough to interfere with your work, your relationships, and your ability to get through the day. About 5-8% of women of reproductive age have it.
Many women with PMDD have been brushed off for years. Told it is just stress, just hormones, just something to push through. PMDD is a real condition with effective treatments. It does not have to run your life.
How We Treat PMDD
SSRIs are the front-line treatment for PMDD and they work well for most patients. Some women take them daily. Others take them only during the luteal phase -- the two weeks before their period. We work with you to find the right timing and the right medication.
Common options include sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro). If SSRIs are not enough, we explore alternatives. When hormonal treatment is part of the picture, we coordinate with your OB-GYN.
What to Expect
We talk about your symptoms, your cycle, and how bad things get. Mood tracking helps -- if you have a log or an app tracking your symptoms, bring it. If not, we may ask you to track for a cycle or two to confirm the pattern.
Insurance and Payment
PMDD evaluation and treatment is covered by most insurance. We accept Blue Cross NC, Aetna, Cigna, UnitedHealthcare, and NC Medicaid. Cash pay is available.
When to Get Help
If the week before your period brings a wave of depression or rage that feels impossible to control. If your relationships take a hit every month on a predictable schedule. If you know something cyclical is happening but nobody has taken it seriously. PMDD is real and it is treatable. Most patients see improvement within the first cycle or two of medication.